RESUMEN
Background: First trimester bleeding is one of the common complications during pregnancy which affects almost 16-25% of all pregnancies. To evaluate and ascertain the adverse maternal and perinatal outcomes in pregnant women presenting with first trimester vaginal bleeding.Methods: Prospective case-control study. A case control study involving 60 pregnant women with vaginal bleeding in the first 13 weeks + 6 days of gestational age with 60 matched controls. The study period was from March 2015 to March 2016 and conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu.Results: The complications seen in the study group were: first trimester abortion (16.7%), second trimester abortion (6.7%), preterm labour (25%), abruption (6.7%), neonatal intensive care admission (25%), ectopic (6.7%), IUGR (10%), IUD (1.7%) and PROM (8.3%). When compared with the parity matched controls there was statistically significant increase in first and second trimester abortions, preterm labour, abruption, NICU admission and ectopic pregnancy whereas there was no significant difference between the two groups with regard to intrauterine growth restriction (IUGR) and intrauterine death (IUD).Conclusions: Women with first trimester vaginal bleeding had several adverse outcomes in both the mother and the fetus, and it is very important to explain about the possibility of these outcomes and ensure proper follow up with close antenatal surveillance.
RESUMEN
Resumen ANTECEDENTES: la progesterona es una hormona esteroide con participación en la ovulación, implantación, embarazo y regulación de la función uterina durante el ciclo menstrual y de otros órganos, como la glándula mamaria. Por su mecanismo de acción, la progesterona está indicada en distintos padecimientos ginecológicos y obstétricos: síndrome premenstrual, amenaza de aborto, parto pretérmino, hemorragia uterina disfuncional y mastalgia relacionada con el ciclo menstrual. OBJETIVO: evaluar la seguridad y eficacia de la progesterona en pacientes con: síndrome premenstrual, amenaza de aborto y de parto pretérmino, hemorragia uterina disfuncional, mastalgia y terapia hormonal en la menopausia. METODOLOGÍA: revisión sistemática de la evidencia científica acerca de las distintas indicaciones de la progesterona. RESULTADOS: se encontraron 92 artículos de los que se seleccionaron 41 para revisión. CONCLUSIONES: la evidencia clínica evaluada acerca de las indicaciones de la progesterona demuestra ventajas en eficacia y seguridad en los diferentes esquemas.
Abstract BACKGROUND: Progesterone is a steroid hormone involved in ovulation, implantation, pregnancy and regulation of uterine function during the menstrual cycle and other organs such as the mammary gland. Because of its mechanism of action, progesterone is indicated in different gynecological and obstetric conditions: premenstrual syndrome, threatened abortion, preterm birth, dysfunctional uterine bleeding and mastalgia related to the menstrual cycle. OBJECTIVE: To evaluate the safety and efficacy of progesterone in patients with: premenstrual syndrome, threatened abortion, preterm birth, dysfunctional uterine bleeding, mastalgia and hormone therapy in menopause. MATERIAL AND METHODS: Systematic review of scientific evidence about different indications of progesterone. RESULTS: We found 92 articles from wich 41 were selected for review. CONCLUSIONS: The clinical evidence evaluated on different indications of progesterone demonstrates advantages in efficacy and safety in different regimens.